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Your complete guide to pre-existing conditions

Nobody likes reading pages upon pages of a jargon-filled insurance policy. Yet doing so is one of the most important (if not the most important) aspects of securing health insurance. This is true for everyone looking to get insured, but especially for those who have a pre-existing condition. If you’re scratching your head in confusion, you’ve come to the right place. Staying true to our motto of ‘simplifying insurance’, this Pacific Prime Singapore article will tell you everything you need to know about pre-existing conditions.

Individual health insurance blog

What is a pre-existing condition?

Put simply, a pre-existing condition is any medical illness or injury that you have before you secure health insurance. Typically, pre-existing conditions are long-term and/or chronic in nature, including cancer, heart diseases, diabetes, and asthma. However, they can also include less serious things such as a broken leg, cold/flu, allergies, and other minor issues. Generally speaking, pre-existing conditions are excluded from coverage by health insurers, so any claims for reimbursements that are related to them won’t be approved. (More on this below).

How are pre-existing conditions determined?

Insurers will ask you to disclose any pre-existing conditions and will then carry out the underwriting process to determine whether or not you can secure the plan, and to determine what your premiums should be. Here are some questions you can ask yourself to figure out if you have a pre-existing condition:

  1. Have you been diagnosed with anything before starting the policy?
  2. Have you been treated or advised to be treated for anything before starting the policy?
  3. Have you been investigated or advised to be investigated for anything before starting the policy?
  4. Have you been given medication or advised to have medication for anything before starting the policy?
  5. Have you been hospitalized or advised to be hospitalized for anything before starting the policy?
  6. Have you had any symptoms before starting the policy?
  7. Have you had anything that has a strong medical indication that it originated before starting the policy? For example, the size of a tumor or stage of cancer.

Word of warning: It’s vital to note that knowingly withholding information from the insurer counts as insurance fraud, and is a growing challenge for insurers – as we found in our Cost of International Health Insurance Report 2020-2021. Download the report for free to learn more!

Is it possible to get coverage for pre-existing conditions?

Health insurers will often exclude coverage for pre-existing conditions, as we touched upon in the previous section. But don’t fret – there are options for you if you’ve got a pre-existing condition. To find a plan that works best for your needs in Singapore, let’s first look at how health insurers in the Lion City respond to pre-existing conditions. Based on over 20 years of experience as an insurance brokerage, we’ve found that insurers usually respond in one of the following ways.

Full coverage (including for your pre-existing conditions)

The good news is that it is possible to get full coverage, which includes your pre-existing conditions as well. What’s more, you won’t have to pay any extra premium over the quoted price (also known as premium loading). That being said, you’ll need to search for insurers and/or plans that offer this.

Coverage for pre-existing conditions with a premium loading

As the next best solution, some plans will offer coverage for pre-existing conditions, but charge an extra premium over the quoted price. Or in other words, add a premium loading. This means you’ll need to pay a higher premium for the insurer to cover your condition. This is one of the cases where it pays to read the fine print.

Coverage for pre-existing conditions after a moratorium or waiting period

Instead of a premium loading, insurers may impose a moratorium or waiting period. What this means is that after securing the plan, you need to wait a certain amount of time (as indicated by the moratorium or the aptly named waiting period) before the insurer will cover your pre-existing conditions. This is usually between 1 to 2 years.

Note: After the moratorium or waiting period has elapsed, some plans may offer coverage for pre-existing conditions based on your plan’s limit, while others may offer coverage at a lower limit.

No coverage for pre-existing conditions

This is the standard coverage for everything, with the exception of your pre-existing conditions. However, do bear in mind that there may be other things in the plan that are also excluded for coverage as well.

Note: You can also check out this video on the 8 most common health insurance exclusions.

No coverage at all

Finally, insurers may not want to provide any coverage at all if you’ve got pre-existing conditions. In plain English, this means you can’t secure the plan. It’s often the worst-case scenario for individuals looking to get insured, which means those with pre-existing conditions end up doing more shopping around for plans than others.

Find an appropriate health insurance plan via Pacific Prime Singapore today!

Speaking of shopping around for plans, now you know that it’s important to evaluate plans on more aspects than simply premiums. We’ve got a dedicated ‘how to compare health insurance’ page which tells you things to consider and points you to our price quotation tool. What’s more, we also recommend that you keep a copy of our insurance glossary handy when evaluating plans.

If you’d rather not bury your heads deep into the policy, and save yourself the time and hassle of finding the most appropriate plan, you’re more than welcome to reach out to us at Pacific Prime Singapore. Whether you’re looking for individual health insurance, family health insurance, or pre-existing condition health insurance in Singapore, we can recommend plans from top insurers in the region.

We’ve also got highly-trained insurance advisors that seek to understand your healthcare needs, provide a tailored plan comparison, and walk you through every step of the way – from help filling out application forms to making claims for reimbursement. The best part? We provide our service completely free of charge versus going directly to the insurer.

Contact us today to get started!

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